Paediatric induction techniques: inhalational versus intravenous, premedication, and the sick child

Model answer

Elective (7). Calm separation first (parental presence reduces anxiety vs none but is less effective than midazolam alone); sevoflurane inhalational induction (8% single-breath method trialled in 5-15 yr olds) or IV where cannulated — GAS equivalence (median 54 min; 2-yr diff 0.169, 5-yr diff 0.23) reassures on brief-exposure neurodevelopment. Screen for recent URTI (OR 2.03) and airway anomaly (OR 3.35), the two case-control laryngospasm risks, and have a plan.^{[6][5][1][2][3]}

Full stomach (8). IV induction with rapid-sequence precautions per paediatric airway guidance and senior help present; gentle ventilation if desaturating given short infant apnoea times.^[4]